Objective: Patients with intractable complex partial seizures are complicated neurological patients to manage clinically, as the severity and nature of neurological degeneration can manifest in chronic and serious symptoms. A review of the literature suggests that the onset of psychotic symptoms in early adulthood is present in patients with intractable epilepsy and brain damage. Method: A comprehensive neuropsychological evaluation was administered to a patient with intractable epilepsy and multiple forms of brain damage as confirmed by neuroimaging (i.e., left parietal injury, mild diffuse cerebral and cerebellar volume loss, and encephalopathy). The patient is treated at an outpatient psychiatric clinic to address multiple psychotic symptoms and a rapid decrease in global functioning. Results: The neuropsychological assessments revealed: severely impaired intellectual ability with intact visuospatial reasoning; grossly impaired language skills (expressive, and receptive); varied memory capacities (i.e., from profound to average); global impairment of executive skills; borderline academic skills; and impaired behavioral and adaptive functioning. Conclusion(s): The findings suggest global impairment consistent with her imaging findings. The pervasive visual hallucinations and paranoid delusions are a product of the multiple forms of brain damage, while the auditory hallucinations are primarily a product of the ictal phases of the seizures. The present case will be presented to contribute to the literature on the poly-etiological development and nature of psychotic symptoms in patients with co-morbid seizure disorders and brain damage.